Cultural understanding, experiences, barriers, and facilitators of healthcare providers when providing preconception counseling to adolescent Latinas with diabetes

Abstract Background Cirrhosis is the leading cause of mortality and morbidity in individuals with gastrointestinal disease. Multiple care gaps exist for hospitalized patients with cirrhosis, resulting in high rates of re-hospitalization (e.g. 44% at 90 days in Alberta). The Cirrhosis Care Alberta (CCAB) is a 4-year multi-component pragmatic trial with an aim to reduce acute-care utilization by implementing an electronic order set and supporting education across eight hospital sites in Alberta. Aims As part of the pre-implementation evaluation, this qualitative study analyzed data from provider focus groups to identify barriers and facilitators to implementation. Methods We conducted focus groups at eight hospital sites with a total of 54 healthcare providers (3–12 per site). A semi-structured interview guide based upon constructs of the Consolidated Framework for Implementation Research (CFIR) and Normalization Process Theory (NPT) frameworks was used to guide the focus groups. Focus groups were recorded and transcribed verbatim. Data was analyzed thematically and inductively. Results Five major themes emerged across all eight sites: (i) understanding past implementation experiences, (ii) resource challenges, (iii) competing priorities among healthcare providers, (iv) system challenges, and (v) urban versus rural differences. Site-specific barriers included perceived lack of patient flow, time restraints, and concerns about the quality and quantity of past implementation interventions. Facilitators included passionate project champions, and an ample feedback process. Conclusions Focus groups were useful for identifying pre-implementation barriers and facilitators of an electronic orders set. Findings from this study are being refined to address the influence of COVID-19, and the data will be used to inform the intervention roll-out at each of the sites. Funding Agencies Alberta Innovates

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Barriers and Facilitators to COVID-19 screening at Jaipur International Airport, India.

10.21203/rs.3.rs-307039/v1 ◽

2021 ◽

Author(s):

Neha Mantri ◽

Nitin Kumar Joshi ◽

Pankaj Bhardwaj ◽

Akhil Dhanesh Goel ◽

Manoj Kumar Gupta ◽

...

Keyword(s):

Disease Transmission ◽

Healthcare Providers ◽

Health Department ◽

International Travel ◽

Barriers And Facilitators ◽

Organization Behavior ◽

Travel History ◽

International Airport ◽

Key Stakeholders ◽

The Mean

Abstract Background:Airports pose a possible threat in facilitating global disease transmission within the community which may be prevented by rigorous systematic entry-exit screening. With the aim to capture the perception of stakeholders associated with COVID-19 on barriers and facilitators of airport screening at Jaipur International Airport. Also, to assess key outcomes viz. total passengers screened, suspected cases, & confirmed cases.Methods:An inductive-deductive mix-method thematic analysis was conducted to capture qualitative data of key stakeholders. Additionally, quantitative data was obtained from the Rajasthan Medical & Health Department team deployed for COVID-19 airport screening.Results:Jaipur International Airport screened 4565 passengers (Males=4073 and Females=492) with 23 suspected cases during an outlined period of declaration of Pandemic to Lockdown in India (11th to 24th March 2020). Total 65 passengers had travel history from China (3 from Wuhan). The mean average age of passengers was 40.95 ± 7.8 years. The average screening time per passenger was 2-3 minutes with a load of 25-90 passengers per team per flight. Fishbone analysis of screening challenges revealed poor cooperation of passengers, masking symptoms, apprehension, and stigma related to quarantine. Moreover, inadequate human resources and changing guidelines overburdened healthcare providers. But, perception of risk, and social responsibility of travelers together with supportive organization behavior act as facilitators. Overall, groundwork on airport screening was insightful to propose key action areas for screening.Conclusions:Globally, COVID-19 has an impact on health infrastructure and international travel. International coordination with streamlined screening will go a LONG way in virus containment.

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International barriers and facilitators for cervical cancer screening among young people: a systematic review

10.22541/au.159620944.40309212/v2 ◽

2021 ◽

Author(s):

Abirami Kirubarajan ◽

Shannon Leung ◽

Xinglin Li ◽

Matthew Yau ◽

Mara Sobel

Keyword(s):

Systematic Review ◽

Cervical Cancer ◽

Cancer Screening ◽

Young People ◽

Cervical Cancer Screening ◽

Low Income ◽

Healthcare Providers ◽

Barriers And Facilitators ◽

Low Income Countries ◽

Age Group

Background Though cervical cancer is one of the leading causes of death globally, its incidence is nearly entirely preventable. Young people have been an international priority for screening. However, in both high-income and low-income countries, young people have not been screened appropriately according to country-specific guidelines and in many countries, screening rates for this age-group have even dropped. Objectives The aim of this systematic review was to systematically characterize the existing literature on barriers and facilitators for cervical cancer screening among young people globally. Search Strategy We conducted a systematic review following PRISMA guidelines of four databases: Medline-OVID, EMBASE, CINAHL, and ClinicalTrials.Gov. Selection Criteria We only examined original, peer-reviewed literature. Databases were examined from inception until the date of our literature searches (12/03/2020). Articles were excluded if they did not specifically discuss cervical cancer screening, were not specific to young people, or did not report outcomes or evaluation. Data Collection and Analysis All screening and extraction was completed in duplicate with two independent reviewers. Main Results Of the 2177 original database citations, we included 36 studies that met inclusion criteria. Our systematic review found that there are three large categories of barriers for young people: lack of knowledge/awareness, negative perceptions of the test, and practical barriers to testing. Facilitators included stronger relationships with healthcare providers, social norms, support from family, and self-efficacy. Conclusions Health systems worldwide should address the barriers and facilitators to increase cervical cancer screening rates in young people. Further research is required to understand this age group.

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I like it but I don’t have time to tell patients’ families: Exploring barriers and facilitators of pain and dementia knowledge flow between healthcare providers and family caregivers

Advances in Aging Research ◽

10.4236/aar.2012.13008 ◽

2012 ◽

Vol 01 (03) ◽

pp. 60-71

Author(s):

Cary A. Brown ◽

Ashley Schmidt

Keyword(s):

Family Caregivers ◽

Healthcare Providers ◽

Barriers And Facilitators ◽

Knowledge Flow

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Barriers and facilitators of completing the steps in the PMTCT cascade at Midwife Obstetric Units in Gauteng - Healthcare Provider and Patient's views

10.21203/rs.3.rs-24824/v1 ◽

2020 ◽

Author(s):

Constance Mongwenyana ◽

Nelly Jinga ◽

Given Mohomi ◽

Sindisiwe Buthelezi ◽

Nancy Nkopane ◽

...

Keyword(s):

Primary Healthcare ◽

Healthcare Providers ◽

Turnaround Time ◽

Postpartum Care ◽

Barriers And Facilitators ◽

Hiv Status ◽

Hiv Diagnosis ◽

Hiv Test ◽

Increase Risk ◽

Pmtct Cascade

Abstract Background: The implementation of Prevention of Mother to Child Transmission (PMTCT) programmes at midwifes obstetric units (MOU) involves the confirmation of HIV diagnosis during labour, early infant HIV diagnosis (EID), initiation/continuation of antiretroviral therapy (ART) for mother and baby as appropriate and counselling for postpartum care. Objectives: The aim of this study was to explore the barriers and facilitators to completing the steps in the PMTCT cascade at MOUs as defined by healthcare providers and recently postpartum women. Methods: We conducted 10 in-depth interviews with healthcare providers, and 24 HIV positive and HIV negative women at the four MOUs and Primary Healthcare Centres (PHC’s) in Gauteng South Africa (SA). Results: The implementation of PMTCT at MOU is impeded by maternal denial of HIV status (both new diagnoses and ANC diagnoses). Challenges with acceptance and disclosure of HIV status were thought to compromise patient commitment to EID tests and postpartum adherence to infant ART. Newly diagnosed (during labour) patients have limited time to process new HIV diagnosis and clinics have limited nurse/counsellor capacity for further one on one counselling. Additional challenges include communication challenges with foreign women and turnaround time for birth HIV tests. Results are often not available at postnatal visit and unclear processes for referral to Primary Healthcare Centre (PHC) for postpartum care increase risk of postpartum loss to follow up. Conclusion: We need to strengthen MOU capacity to prepare women for postpartum PMTCT requirements and facilitate access to EID results. Patient referral processes, including communication of infant HIV test results to the referral PHC, needs improvement.

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Implementing health technology assessment in Kuwait: a qualitative study of perceived barriers and facilitators

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462319000710 ◽

2019 ◽

Vol 35 (6) ◽

pp. 422-426 ◽

Cited By ~ 1

Author(s):

Basshar Darawsheh ◽

Evi Germeni

Keyword(s):

Developing Countries ◽

Health Technology Assessment ◽

Technology Assessment ◽

Qualitative Interviews ◽

Healthcare Providers ◽

Health Technology ◽

Barriers And Facilitators ◽

Policy Makers ◽

Face To Face ◽

Key Stakeholders

AbstractObjectivesThis study sought to explore main barriers and facilitators to implementing health technology assessment (HTA) in Kuwait from the perspective of key stakeholders.MethodsSemi-structured qualitative interviews were conducted with ten key stakeholders: seven healthcare providers working at various departments of the Kuwaiti Ministry of Health (MOH), and three academics with substantial experience in teaching HTA or related fields. Interviews were conducted face-to-face, audio-recorded, and transcribed verbatim. Data were analyzed using an inductive thematic approach.ResultsParticipating stakeholders reported several factors that might act as a barrier to building HTA in Kuwait: minimal awareness of HTA, lack of institutional and human capacity, a fragmented healthcare system, poor communication between researchers and policy makers, the country's wealth, politics, as well as data quality, availability, and sharing. Institutionalizing HTA as a politically empowered body, enforcing its recommendation by law, and benefiting from neighboring countries' experiences were suggested as possible ways to move forward.ConclusionStudies exploring the unique challenges that high-income developing countries may face in implementing HTA are still scarce. The results of this study are consistent with evidence coming from other developing countries, while also suggesting that the abundance of financial resources in the country is a double-edged sword; it has the potential to facilitate the development of HTA capacity, but also hinders recognizing the need for it.

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Barriers and facilitators of the use of mind-body therapies by healthcare providers and clinicians to care for themselves

Complementary Therapies in Clinical Practice ◽

10.1016/j.ctcp.2015.01.004 ◽

2015 ◽

Vol 21 (2) ◽

pp. 124-130 ◽

Cited By ~ 5

Author(s):

Sylvanus Brenya Mensah ◽

Joel G. Anderson

Keyword(s):

Healthcare Providers ◽

Barriers And Facilitators

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Barriers and facilitators to adopting high value practices and de-adopting low value practices in Canadian intensive care units: a multimethod study

BMJ Open ◽

10.1136/bmjopen-2018-024159 ◽

2019 ◽

Vol 9 (3) ◽

pp. e024159 ◽

Cited By ~ 5

Author(s):

Khara Sauro ◽

Sean M Bagshaw ◽

Daniel Niven ◽

Andrea Soo ◽

Rebecca Brundin-Mather ◽

...

Keyword(s):

Intensive Care ◽

Intensive Care Units ◽

Fluid Resuscitation ◽

Healthcare Providers ◽

Population Based ◽

Barriers And Facilitators ◽

Cross Sectional Survey ◽

Surgical Intensive Care ◽

Cross Sectional ◽

Vte Prophylaxis

ObjectiveTo compare and contrast illustrative examples of the adoption of high value practices and the de-adoption of low value practices.Design(1) Retrospective, population-based audit of low molecular weight heparin (LMWH) for venous thromboembolism (VTE) prophylaxis (high value practice) and albumin for fluid resuscitation (low value practice) and (2) cross-sectional survey of healthcare providers.SettingData were collected from nine adult medical-surgical intensive care units (ICUs) in two large Canadian cities. Patients are managed in these ICUs by a group of multiprofessional and multidisciplinary healthcare providers.ParticipantsParticipants included 6946 ICU admissions and 309 healthcare providers from the same ICUs.Main outcome measures(1) The use of LMWH for VTE prophylaxis (per cent ICU days) and albumin for fluid resuscitation (per cent of patients); and (2) provider knowledge of evidence underpinning these practices, and barriers and facilitators to adopt and de-adopt these practices.ResultsLMWH was administered on 38.7% of ICU days, and 20.0% of patients received albumin.Most participants had knowledge of evidence underpinning VTE prophylaxis and fluid resuscitation (59.1% and 84.2%, respectively). Providers perceived these practices to be followed. The most commonly reported barrier to adoption was insufficient knowledge/understanding (32.8%), and to de-adoption was clinical leader preferences (33.2%). On-site education was the most commonly identified facilitator for adoption and de-adoption (67.8% and 68.6%, respectively).ConclusionsDespite knowledge of and self-reported adherence to best practices, the audit demonstrated opportunity to improve. Provider-reported barriers and facilitators to adoption and de-adoption are broadly similar.

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Barriers and facilitators to adherence to anti-diabetic medications: Ethiopian patients’ perspectives

African Journal of Primary Health Care & Family Medicine ◽

10.4102/phcfm.v9i1.1411 ◽

2017 ◽

Vol 9 (1) ◽

Cited By ~ 7

Author(s):

Bruck M. Habte ◽

Tedla Kebede ◽

Teferi G. Fenta ◽

Heather Boon

Keyword(s):

Diabetes Education ◽

Healthcare Providers ◽

Common Factors ◽

Public Hospitals ◽

Barriers And Facilitators ◽

Structured Interviews ◽

Religious Healing ◽

Number Of Factors ◽

Open Coding

Background: Little is known about the experiences of Ethiopian patients with type 2 diabetes related to adherence to their anti-diabetic medications. This may limit attempts to develop and implement patient-centred approaches that consider Ethiopian contexts.Objectives: To conduct an exploratory study with a focus on identifying barriers and facilitators to anti-diabetic medications adherence in Ethiopian patients with type 2 diabetes.Methods: Qualitative methods were used to conduct semi-structured interviews with 39 purposively selected participants attending clinic in three public hospitals in central Ethiopia. Open coding was used to analyse the data to identify key themes.Results: A number of factors were identified as barriers and facilitators to participants’ adherence to their anti-diabetic medications. The most common factors were perceptions related to their illness including symptoms, consequences and curability; perceptions of medications including safety concerns, convenience and their necessity; religious healing practices and beliefs; perceptions about and experiences with their healthcare providers and the healthcare system including the availability of medications and diabetes education; and finally perceived self-efficacy and social support.Conclusions: The findings of this study provide guidance to strengthen diabetes education programmes so that they reflect local patient contexts focusing among other things on the illness itself and the anti-diabetic medications.

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